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FEBRUARY ENROLLMENT UPDATE: 4.2 MILLION — Enrollment in the Obamacare insurance exchanges has ticked up to 4.2 million as of last month, the Obama administration announced yesterday. So what does that mean for the final lap? The numbers aren’t a disaster — the February daily signup rate was about the same as January’s once the slightly different time frameworks of the monthly reports are taken into account. But still, that rate would have to roughly double for the administration to reach its revised 6 million goal by the end of March.

—As for the coveted young adult enrollees, about a quarter of total signups so far are between ages 18 and 35. Other data points: more than four in five people qualified for subsidies, 55 percent of enrollees are women and nearly two-thirds of all sign-ups selected mid-level “silver” plans. Officials still haven’t announced how many people have paid their premiums. More takeaways: http://politi.co/1lTp2x9

—The right-leaning American Action Forum compares the data to three potential benchmarks: the administration’s original enrollment goals, initial enrollment in Medicare Part D and a steady enrollment trajectory. http://bit.ly/1oJL2HO

ENROLLMENT DAYS REMAINING: 20. In case you need a reminder from time-to-time, the White House has posted a countdown clock online: http://1.usa.gov/1iymBQm

HAPPENING TODAY — HHS Secretary Kathleen Sebelius heads to the House Ways and Means Committee at 10 a.m. to testify about President Obama’s proposed 2015 HHS budget. Watch here: http://bit.ly/1bvaSsPWhite House Senior Adviser Valerie Jarrett will join editors of Cosmopolitan and Cosmo for Latinas on Google+ at 3 p.m. to chat about enrollment. http://bit.ly/1ixHCGh

Welcome to Wednesday. Readers, you really should celebrate the midweek point with some cheese, because it might not be long before your feta is renamed. Apparently the EU is trying to restrict U.S. farmers from using dozens of common cheese names under the argument that they could be considered “geographical indicators.” PULSE is glad Congress appears outraged by this proposition. Because really, would Asiago by any other name taste as good? As Sen. Chuck Schumer put it, “Muenster is Muenster, no matter how you slice it.”

“I can see PULSE now, the rain is gone.”

‘NO PLANS’ TO EXTEND ENROLLMENT — Administration officials also said yesterday they have “no plans” to extend the open enrollment period past March 31 and argued they lack the legal authority anyway. “We don’t actually have the statutory authority to extend the open enrollment in 2014,” said CMS spokeswoman Julie Bataille.

—But Brian Haile, senior vice president of health policy for Jackson Hewitt Tax Services, told PULSE that claim is “bogus” and said it’s a much more “narrowly literal approach” to interpreting the law than the administration typically takes. According to Haile, the secretary is broadly empowered to establish a special enrollment period. “They simply cannot say that they lack statutory authority,” he said. “This is a policy choice rather than a legal constraint and should be stated as such.”

SGR CHATTER — There was plenty of that on the Hill today. Especially considering only 20 days remain before the current patch on Medicare doctors’ payments runs out. And considering House Republicans plan to vote Friday on the consensus repeal-and-replace bill — but will essentially kill it by using a repeal of the ACA’s individual mandate to pay for it.

—Senate Minority Leader Mitch McConnell called the House pay-for “great,” while his Democratic counterpart Harry Reid said it has “no credibility” and told the GOP “they gotta find something else.” Meanwhile, the House GOP Doctors Caucus urged colleagues to support the bill, writing that it will create an “opportunity for our Senate colleagues to act as they see fit.” And 14 surgeon trade groups wrote to House and Senate leadership begging them to find a pay-for both sides can agree to before the end of the month. The Doctors Caucus letter: http://1.usa.gov/Pqm4mJ The surgeons’ letter: http://politico.pro/N4Ha8h

HOUSE PASSES THREE O-CARE CHANGES — And they were about as non-contentious as they could have been. The first one — expanding the religious exemption from the health care law’s individual mandate — passed by voice vote. The second, which removes vets with TRICARE from the worker headcount that triggers the employer mandate, passed 401-1. And the third, which would also remove volunteer emergency workers from the headcount trigger, passed unanimously. Enjoy the momentary bipartisanship, folks.

CALIFORNIA RULES — The state has enrolled nearly twice as many people in its exchange as the next closest state. It’s got 868,000 signed up, compared to 442,000 in Florida. In related news, enrollment in red states slowed in February although it was still faster growing than in blue states. The Massachusetts exchange — which is recovering from a botched rollout — saw enrollment climb nearly 60 percent, and Nevada, where a massive technical failure in January led to virtually no new enrollments that month, saw its enrollment climb by about 25 percent in February.

** A message from AHCA. Skilled nursing has been tasked with a challenge: continue to improve quality care for millions of Americans and do so on razor-thin 1.8 percent margins. Even still, the long term and post-acute care profession continues to improve lives by delivering solutions for quality care. We are AHCA. And we are the solution. Learn more at ahcancal.org/solutions. **

JOLLY DEFEATS SINK — Republican David Jolly is probably quite jolly after defeating Democrat Alex Sink yesterday in the special election for Florida’s 13th District. “Democrats and the GOP plowed millions of dollars into the race in the hope that it would give them a boost heading into the midterms,” POLITICO’s Alex Isenstadt writes. “The GOP, which focused its attacks on linking Sink to Obamacare, managed to win with an untested candidate with whom many in the national party had grown frustrated.” http://politi.co/1lTXJTo

MA CUTS — Oliver Wyman has released more analysis of how the administration’s proposed Medicare Advantage cuts could affect seniors’ premiums, benefits and coverage options — this time state-by-state. The firm projects that premiums could increase the most in Alabama, Hawaii, New Jersey, New York and Texas. Increases could be lowest in North and South Dakota and Montana. The report was commissioned by America’s Health Insurance Plans. Final rates will be announced on April 7. The analysis: http://bit.ly/1epTdEs

NO NUTRITION LABEL UPDATES UNTIL 2018? — The Obama administration might be hoping to get Nutrition Facts labels updated before the president leaves office, but a longtime nutrition labeling expert says that’s most likely wishful thinking. Karen Duester, president of Food Consulting Company, told POLITICO she thinks the final enforcement date won’t be until January 2018. That’s because a lot of things have to happen first: a 90- or 180- day comment period, review of all the comments, crafting a final rule and then giving companies two years to get in compliance. ICYMI, our story on the proposed changes: http://politi.co/NYwWat

BIPARTISAN BILL FOR PHARMACIES IN UNDERSERVED AREAS — Three House members have introduced a bipartisan bill allowing pharmacists in medically underserved areas to be reimbursed by Medicare for providing additional services like immunizations, diabetes management, blood pressure screenings and routine checks. H.R. 4190 is sponsored by Reps. Brett Guthrie (R-Ky.), G.K. Butterfield (D-N.C.) and Todd Young (R-Ind.).

SGR BILL TO SENATE FLOOR? Senate Democrats on Tuesday "Rule 14'ed" the permanent SGR repeal bill — or in other words, set it up for action on the Senate floor. The extenders approved by the Finance Committee were added and no pay-fors were added. The Senate is expected to take it up sometime in the near future (but not this week) and so far it’s unclear whether any pay-fors would be added. It comes just as the House is preparing to vote on an SGR bill paid for by repealing the individual mandate for five years. Senate Majority Leader Harry Reid has made clear that the House's bill is DOA in the Senate. All of this means a nine-month patch is all but certain to be needed when the latest doc fix expires on March 31.

WHAT WE’RE READING, By Joanne Kenen

A WSJ opinion essay suggests the “hardship exemption” from the individual mandate for people with cancelled plans is being extended in the small print of a recent HHS rule, http://on.wsj.com/1oKZOOG

PolitiFact notes that President Obama overstated the uninsurance rate for youth in his “Two Ferns” appearance: http://bit.ly/NY3gdI

The Washington Post FactChecker adds another Pinocchio to that AFP ad by the Michigan cancer patient : http://wapo.st/1fpomw1

John McCormack in The Weekly Standard wonders why HHS can’t change the March 31 deadline but has changed so many other aspects of the ACA : http://tws.io/1qtPgqU

Scientist calls for stem cell papers to be withdrawn after questions arise, the LA Times reports http://lat.ms/1iyhMSD

More young adults taking ADHD drugs, raising questions about overdiagnosis, the New York Times reports. http://nyti.ms/1hbaROq

** The skilled nursing and assisted living profession is not a bystander in the budget debate. Our long term and post-acute care providers know that smart policies result in better care and more balanced budgets. With operating margins teetering dangerously at 1.8 percent, we know that actions must take the place of rhetoric. Our profession is offering solutions to issues that make a difference in patients' lives and Medicare's budget, such as reducing hospital readmissions, improving patient outcomes and increasing quality care in America's skilled nursing and post-acute care centers. But these solutions are just the beginning. We are AHCA and NCAL. And we are the solution. Learn more at ahcancal.org/solutions. **